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UnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… Code 59 (Report 2013-S-82 ). Background The New York State Health Insurance Program (NYSHIP) provides health insurance … Service (Department) contracts with UnitedHealthcare (United) to process and pay medical and surgical claims for services provided to Empire Plan members. United’s payments to medical providers are based, in part, on …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followInfant and Child Learning Center – The Research Foundation for the State University of New York: Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Infant and Child Learning Center - The Research Foundation for the … directly related to the special education program, and sufficiently documented pursuant to the State Education … on ICLC’s CFR for the fiscal year ended June 30, 2015 and certain expenses claimed on its CFRs for the two fiscal …
https://www.osc.ny.gov/state-agencies/audits/2018/06/06/infant-and-child-learning-center-research-foundation-state-university-new-york-complianceSecurity and Effectiveness of Division of Criminal Justice Services' Core Systems (Follow-Up)
… of a disaster or mishap that disables normal processing. We found that ITS did not have established policies and … procedures for backup of key Division systems. Also, ITS does not have an active regional backup site, and Division … for total data loss in the event of a regional disaster. We also found ITS did not comply with certain State …
https://www.osc.ny.gov/state-agencies/audits/2017/04/07/security-and-effectiveness-division-criminal-justice-services-core-systems-followFood Safety Monitoring (Follow-Up)
… Our initial audit report was issued on January 30, 2014 and covered the period of April 1, 2011 through September 18, … monitors the processing, distribution, and sale of food products in New York State. During the original audit, we found that the Department’s Division of Food Safety and Inspection (Division) was unable to meet the …
https://www.osc.ny.gov/state-agencies/audits/2015/07/06/food-safety-monitoring-followUnified Court System Bulletin No. UCS-362
… is to notify agencies of an automatic dues increase for employees represented by the Ninth Judicial District … Association dated February 17, 2026 membership dues for employees in Bargaining Unit G9 (Deduction Code 458) will … is to notify agencies of an automatic dues increase for employees represented by the Ninth Judicial District …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-362-ninth-judicial-district-court-employees-association-duesNew York State Health Insurance Program – Payments by Empire BlueCross for Hospital Services for Ineligible Members (Follow-Up)
… our initial audit report, Payments by Empire BlueCross for Hospital Services for Ineligible Members (Report 2019-S-32 ). … Empire BlueCross (Empire) to administer the Empire Plan’s hospital benefits. Civil Service maintains the New York … August 18, 2020, sought to determine whether Empire paid hospital claims for members who were not eligible for …
https://www.osc.ny.gov/state-agencies/audits/2021/12/27/new-york-state-health-insurance-program-payments-empire-bluecross-hospital-servicesAccuracy of Medicaid Eligibility Determined by NY State of Health (Follow-Up)
… report, Accuracy of Medicaid Eligibility Determined by NY State of Health (Report 2019-S-43 ). About the Program NY State of Health (NYSOH) is the online health plan … report Accuracy of Medicaid Eligibility Determined by NY State of Health Report 2019S43 …
https://www.osc.ny.gov/state-agencies/audits/2022/09/30/accuracy-medicaid-eligibility-determined-ny-state-health-followHealth, Safety, and Accessibility in District 75 Schools
… District 75’s network of facilities includes 59 main sites/schools, each with one or more affiliated satellite schools. Students in District 75 main sites and satellite schools receive their services in … schools located throughout the five boroughs of NYC – 15 main sites/schools and 14 satellite schools – and determined …
https://www.osc.ny.gov/state-agencies/audits/2021/04/12/health-safety-and-accessibility-district-75-schoolsOverpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… included in our initial audit report, Overpayments for Therapy Services and Prescription Drugs Covered by Medicare … Medicare program covers physical, occupational, and speech therapy services as well as prescription drugs. When these … overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered by …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followOpioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program (Follow-Up)
… Opioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program (Report 2017-S-66 ). About the Program Opioid treatment programs (Treatment Programs) provide medication-assisted treatment, … Opioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program Report 2017S66 …
https://www.osc.ny.gov/state-agencies/audits/2020/05/07/opioid-prescriptions-medicaid-recipients-opioid-treatment-program-followReimbursement of Homeless Shelter Providers – Westhab Inc.’s Coachman Family Center (Follow-Up)
… working with the Local Districts to ensure that all required documents have been included, and assessing budgeted … January 2019 through December 2019 and select expenses from 2020. Overall, the audit found that OTDA was not … Key Recommendation OTDA officials are requested, but not required, to provide information about any actions planned to …
https://www.osc.ny.gov/state-agencies/audits/2024/08/08/reimbursement-homeless-shelter-providers-westhab-incs-coachman-family-center-followReimbursement of Homeless Shelter Providers – Rescue Mission Alliance of Syracuse (Follow-Up)
… and Disability Assistance (OTDA) administers programs for the State’s low-income residents and provides support, … State. Local Districts' annual claims submission to OTDA for homeless housing was $2 billion or more for calendar years 2019 through 2022. The Onondaga County …
https://www.osc.ny.gov/state-agencies/audits/2024/07/26/reimbursement-homeless-shelter-providers-rescue-mission-alliance-syracuse-followNew York State Health Insurance Program – Payments by CVS Health for Pharmacy Services for Ineligible Members (Follow-Up)
… behalf. Our initial audit report, issued on September 29, 2021, determined if CVS paid pharmacy claims for Empire …
https://www.osc.ny.gov/state-agencies/audits/2023/01/04/new-york-state-health-insurance-program-payments-cvs-health-pharmacy-services-ineligibleRolling Stock Programs Department – Selected Aspects of the M9 Rail Car Project Management (Follow-Up)
… of implementation of the 12 recommendations included in our initial audit report, Rolling Stock Programs Department – Selected Aspects of the M9 Rail Car Project Management (Report 2020-S-50 ). About the … Road (LIRR) is one of the oldest commuter railroads still in operation today with a charter dating back to the 1830s. …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/rolling-stock-programs-department-selected-aspects-m9-rail-car-project-management-followMainstream Managed Care Organizations – Administrative Costs Used in Premium Rate Setting (Follow-Up)
… assess any contracted actuarial costs against the MCOs, as required by law. We recommended that the Department modify … on our findings; recover the corresponding overpayments from all mainstream MCOs based on the recalculated premiums; … has assessed contracted actuarial costs to MCOs as required. Key Recommendation Officials are given 30 days …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/mainstream-managed-care-organizations-administrative-costs-used-premium-rate-setting-followErrors in Identification of 340B Providers in the Medicaid Drug Rebate Program (Follow-Up)
… in 1992. The 340B program requires drug manufacturers to discount the price of drugs sold to eligible health care …
https://www.osc.ny.gov/state-agencies/audits/2018/10/23/errors-identification-340b-providers-medicaid-drug-rebate-program-followMonitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance (Follow-Up)
… to promote public welfare and to prevent cemeteries from falling into disrepair or insolvency. Our initial audit …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/monitoring-not-profit-cemeteries-fiscal-stability-and-adequate-facility-maintenance-followCollection of Special Hauling and Divisible Load Overweight Permit Fees (Follow-Up)
… Department of Transportation (Department) is responsible for regulating the movement of oversize and overweight … of equipment or other item that exceeds legal dimensions for the highway but cannot be broken down into smaller … help ensure a safe and efficient transportation system for the traveling public and protect the integrity and …
https://www.osc.ny.gov/state-agencies/audits/2019/09/27/collection-special-hauling-and-divisible-load-overweight-permit-fees-followCUNY Bulletin No. CU-857
… is to notify agencies of an automatic dues increase for employees represented by DC37, Local 2054 in Bargaining … is to notify agencies of an automatic dues increase for employees represented by DC37 Local 2054 in Bargaining …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-857-district-council-37-dc37-local-2054-dues-increaseCUNY Bulletin No. CU-861
… represented by DC37, Local 384 in Bargaining Units CC, CD, and TH. Affected Employees: Employees represented by DC37, Local 384 in Bargaining Units CC, CD, and TH are affected. Background: Per the request from … 6,2026, membership dues for employees in Bargaining Units CC, CD, and TH (Deduction Code 259) will increase as outlined …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-861-district-council-37-dc37-local-384-dues-increase